One century after the discovery of insulin, the French Health regulations have just authorized the reimbursement for islet transplantation. Intraportal islet allotransplantation from a pancreatic donor is indicated in patients with type 1 diabetes (T1D) complicated with lability or hypoglycemia unawareness, or in case of a functioning kidney graft; islet auto-transplantation may be indicated after pancreatic surgery.Compared with insulin even administered in closed-loop pumps, the specificity of islet allotransplantation is the restoration of C-peptide secretion. Long-term insulin-independence is observed when the engrafted islet mass is sufficient, at the cost of immunosuppression. Fewer low-glucose events and less glucose variability, are observed even with minimal functional islet graft, after islet transplantation as at onset of T1D, when a residual C-peptide secretion is maintained, an objective currently approached with less aggressive immuno-modulating therapies than in the past. Therefore, restoration or preservation of endogen insulin secretion is an important goal, allowing to maintain a long-term glucose balance with more than 70% of time in range 3.9-10 mmol/L and less than 3% of time < 3.9mmol/L, thus reducing the occurrence of diabetic complications. In the clinical setting, - the preservation of C-peptide at early stage of T1D, - the use of technological ressources (multi-injections, sensors, insulin pump, closed-loop systems) at later stages, – and islet transplantation when hypoglycemia awareness becomes impaired are complementary for a personalized care all along the life of T1D patients.

在发现胰岛素一个世纪后，法国卫生法规刚刚批准了胰岛移植的报销。来自胰腺供体的门静脉内胰岛同种异体移植适用于 1 型糖尿病 (T1D) 合并不稳定或低血糖无意识的患者，或功能正常的肾移植物；胰岛手术后可能需要胰岛自体移植。与胰岛素甚至在闭环泵中给药相比，胰岛异体移植的特异性是恢复C肽分泌。当移植的胰岛质量足够时，以免疫抑制为代价，观察到长期不依赖胰岛素​​。在胰岛移植后，在 T1D 发病时，即使使用最小的功能性胰岛移植，也观察到较少的低葡萄糖事件和较少的葡萄糖变异性，当残留的 C 肽分泌得以维持时，目前的目标是通过比过去更不激进的免疫调节疗法来实现。因此，恢复或保存内源性胰岛素分泌是一个重要目标，允许在超过 70% 的时间范围内维持长期葡萄糖平衡 3.9-10 mmol/L和小于3%的时间<  3.9mmol/L，从而减少了糖尿病并发症的发生。在临床环境中， - 在 T1D 早期保存 C 肽， - 在后期使用技术资源（多次注射、传感器、胰岛素泵、闭环系统）， - 以及低血糖意识时的胰岛移植在 T1D 患者的整个生命周期中，变得受损是个性化护理的补充。